Yenidoğanda orogastrik sonda yerleştirme işlemi sırasında emzik ve dekstrozlu emzik kullanımının ağrıyı azaltmadaki etkisi
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Date
2020-02-18
Authors
Akkaya, Ayşenur
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Araştırma yenidoğanda orogastrik sonda (OGS) yerleştirme işlemi sırasında emzik ve dekstrozlu emzik kullanımının ağrıyı azaltmadaki etkisinin incelenmesi amacıyla randomize kontrollü deneysel araştırma olarak yapıldı. Evrenini İstanbul Tuzla Devlet Hastanesi Yenidoğan Yoğun Bakım Ünitesine Nisan-Aralık 2019 tarihleri arasında yatan term yenidoğanlar oluşturdu. Örneklem grubu ise 60 (kontrol grubu 20, müdahale grubu; yalnız emzik verilen 20, dekstrozla tatlandırılmış emzik verilen 20) yenidoğandan oluşturuldu. OGS yerleştirme işleminden 2 dakika önce müdahale gruplarındaki 20 bebeğe yalnız emzik, 20 bebeğe dekstrozla tatlandırılmış emzik verildi. İşlem emzik kenarından sondayı sızdırma şeklinde gerçekleştirildi. Kontrol grubuna rutin OGS yerleştirme işlemi gerçekleştirildi. Veri toplama süreci kamera ile kaydedildi. Veri toplama aracı olarak: emzik, %25 dekstroz, kamera, monitör, bebek ve anneye ait özellikleri içeren bilgi formu ve buna ek olarak fizyolojik ağrı yanıtlarından en yüksek kalp atım hızı ve en düşük oksijen satürasyonu, davranışsal ağrı yanıtlarından ağlama süresi ve ağrı değerlendirmesinde Yenidoğan Ağrı Değerlendirme Skalası (NIPS) kullanıldı. Araştırmanın istatistiksel analizlerinde Varyans analizi, Shapiro Wilk, Kruskal Wallis, ki-kare, Dunn Bonferro ve Wilcoxon testleri kullanıldı. İstatistiksel analizlerde SPSS v22 paket programı kullanılmış olup anlamlılık düzeyi α=0,05 alınmıştır. İşleme başlamadan önce gruplar ağrı şiddetlerini etkileyebilecek yenidoğan ve anneye ait özellikler gibi değişkenler açısından benzerdi (p>0,05). Yenidoğanlarda emzik ve %25 dekstrozla tatlandırılmış emzik kullanımı OGS yerleştirme işlemi sırasında ve sonrasında oluşan ağrı şiddetini benzer oranlarda azalttıkları aynı zamanda müdahale gruplarındaki yenidoğanların kontrol grubuna göre daha az davranışsal ve fizyolojik ağrı yanıtları gösterdikleri bulundu. Kontrol grubunda işlem sırası ve sonrasında ağrı şiddetinde artış ve daha fazla davranışsal ve fizyolojik ağrı yanıtı görüldü. Emziğin %25 dekstrozla tatlandırılarak kullanımının ağlama süresini azaltmada diğer gruplara göre daha etkili olduğu görülmüştür.
The study was carried out as a randomized controlled experimental study in order to evaluate the effect of the use of pacifier and pacifier with dextrose in reducing pain while inserting the orogastric tube (OGT) in newborns. The population consisted of term newborns who were hospitalized in Istanbul Tuzla State Hospital Neonatal Intensive Care Unit between April and December 2019. The sample group consisted of 60 newborns (Control group: 20, Intervention group with only pacifier:20, with dextrose flavored pacifier:20). 20 babies in the intervention group were given only pacifier and 20 babies were given a pacifier flavored with dextrose 2 minutes before the OGT insertion. The procedure was performed by leaking the tube from the edge of the pacifier. Routine OGT insertion was performed in the control group. The data collection process was recorded with a camera. The data were collected using a pacifier, 25% dextrose, camera, monitor, information form including the characteristics of the infant and mother, the highest heart rate and lowest oxygen saturation from physiological pain responses, duration of crying from behavioral pain responses. Additionally, the Neonatal Infant Pain Scale (NIPS) was used for pain assessment. Variance analysis, Shapiro Wilk, Kruskal Wallis, Chi-square, Dunn Bonferro and Wilcoxon tests were used in the statistical analysis of the study. The SPSS v22 package program was used for statistical analysis and the significance level was taken α=0.05. Prior to the procedure, the groups were similar in terms of variables such as newborn and maternal characteristics that may affect the severity of pain (p>0.05). It was found that the use of pacifier and 25% dextrose-flavored pacifier in newborns reduced the severity of pain (NIPS) during and after OGT insertion and that newborns in the intervention groups showed less behavioral and physiological pain responses than the control group. In the control group, increased pain severity (NIPS) and more behavioral and physiological pain responses were observed during and after the procedure. The use of 25% dextrose-flavored pacifier has been shown to be more effective in reducing the duration of crying compared to other groups.
The study was carried out as a randomized controlled experimental study in order to evaluate the effect of the use of pacifier and pacifier with dextrose in reducing pain while inserting the orogastric tube (OGT) in newborns. The population consisted of term newborns who were hospitalized in Istanbul Tuzla State Hospital Neonatal Intensive Care Unit between April and December 2019. The sample group consisted of 60 newborns (Control group: 20, Intervention group with only pacifier:20, with dextrose flavored pacifier:20). 20 babies in the intervention group were given only pacifier and 20 babies were given a pacifier flavored with dextrose 2 minutes before the OGT insertion. The procedure was performed by leaking the tube from the edge of the pacifier. Routine OGT insertion was performed in the control group. The data collection process was recorded with a camera. The data were collected using a pacifier, 25% dextrose, camera, monitor, information form including the characteristics of the infant and mother, the highest heart rate and lowest oxygen saturation from physiological pain responses, duration of crying from behavioral pain responses. Additionally, the Neonatal Infant Pain Scale (NIPS) was used for pain assessment. Variance analysis, Shapiro Wilk, Kruskal Wallis, Chi-square, Dunn Bonferro and Wilcoxon tests were used in the statistical analysis of the study. The SPSS v22 package program was used for statistical analysis and the significance level was taken α=0.05. Prior to the procedure, the groups were similar in terms of variables such as newborn and maternal characteristics that may affect the severity of pain (p>0.05). It was found that the use of pacifier and 25% dextrose-flavored pacifier in newborns reduced the severity of pain (NIPS) during and after OGT insertion and that newborns in the intervention groups showed less behavioral and physiological pain responses than the control group. In the control group, increased pain severity (NIPS) and more behavioral and physiological pain responses were observed during and after the procedure. The use of 25% dextrose-flavored pacifier has been shown to be more effective in reducing the duration of crying compared to other groups.
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Keywords
Yenidoğan, Ağrı, Emzik, %25 dekstroz, NIPS, Newborn, Pain, Pacifier, %25 Dextrose
Citation
Akkaya, A. (2020). Yenidoğanda orogastrik sonda yerleştirme işlemi sırasında emzik ve dekstrozlu emzik kullanımının ağrıyı azaltmadaki etkisi. Yayınlanmamış yüksek lisans tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.